Abstract
To investigate the associated risk factors affecting necrosis of the nasal septal mucosal flap (NSF) after salvage surgery for recurrent nasopharyngeal carcinoma (NPC). A retrospective analysis was conducted on patients with recurrent NPC who underwent endoscopic salvage surgery and NSF repair. Factors analyzed included second-course radiotherapy history, recurrence T stage, recurrence time, and postoperative packing time. Logistic regression identified independent risk factors. Second-course radiotherapy, advanced T stage recurrence, longer recurrence time, and shorter postoperative packing time were identified as independent risk factors for NSF necrosis. Patients with second-course radiotherapy had an 8.338 times higher risk of flap necrosis. Advanced T stage and longer recurrence times were also associated with increased risk. Nasal packing for less than 5 days presented a higher risk of flap necrosis compared to packing for 5 days or more. The predictive model demonstrated good predictive ability. The second-course radiotherapy history, the recurrence T stage, the recurrence time, and the postoperative packing time are independent risk factors for necrosis of the nasal septal mucosal flap after salvage surgery for recurrent nasopharyngeal carcinoma.